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ICD-10 Guide
ICD-10 CodesJ45.30

J45.30

Mild persistent asthma, uncomplicated

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 J45.30 is a billable code used to indicate a diagnosis of mild persistent asthma, uncomplicated.

Key Diagnostic Point:

Mild persistent asthma, uncomplicated, is characterized by symptoms occurring more than twice a week but less than once a day. Patients may experience nighttime symptoms more than twice a month, and their lung function is typically normal between exacerbations. The respiratory system, particularly the bronchi and bronchioles, is primarily affected, leading to inflammation, bronchoconstriction, and increased mucus production. This condition can progress if not managed properly, potentially leading to more severe asthma forms. Diagnostic considerations include a thorough patient history, physical examination, and spirometry to assess lung function. Peak flow monitoring may also be utilized to evaluate the severity of asthma and guide treatment decisions. Patients often respond well to inhaled corticosteroids and bronchodilators, which help control symptoms and prevent exacerbations. Regular follow-ups are essential to monitor the condition and adjust treatment as necessary.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as it requires differentiation from other respiratory conditions.
  • Treatment complexity: Moderate, involving ongoing management and potential medication adjustments.
  • Documentation requirements: Moderate, necessitating detailed symptom tracking and treatment responses.
  • Coding specificity: High, as it specifically identifies mild persistent asthma without complications.

Audit Risk Factors

  • Common coding errors: Misclassification of asthma severity.
  • Documentation gaps: Incomplete symptom tracking or lack of treatment response documentation.
  • Billing challenges: Potential denials due to insufficient documentation supporting the diagnosis.

Specialty Focus

Medical Specialties

Primary medical specialty: Pulmonology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Secondary specialty: Allergy and Immunology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Mild persistent asthma affects a significant portion of the population, impacting quality of life and healthcare utilization. Effective management is crucial to prevent progression to more severe asthma, which can lead to increased emergency room visits and hospitalizations. Quality measures for asthma management focus on symptom control and medication adherence, highlighting the importance of regular follow-ups and patient education in improving health outcomes.

ICD-9 vs ICD-10

Mild persistent asthma affects a significant portion of the population, impacting quality of life and healthcare utilization. Effective management is crucial to prevent progression to more severe asthma, which can lead to increased emergency room visits and hospitalizations. Quality measures for asthma management focus on symptom control and medication adherence, highlighting the importance of regular follow-ups and patient education in improving health outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is supported by clinical evidence and that the treatment aligns with established guidelines. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for prescribed treatments. Coders should ensure that all relevant information is captured in the medical record to support the claim and reduce the risk of audits.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for J00-J99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for J00-J99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by J45.30?

J45.30 specifically covers mild persistent asthma, which includes patients experiencing symptoms more than twice a week but less than daily, with nighttime symptoms occurring more than twice a month. It does not include patients with more severe forms of asthma or those with complications.

When should J45.30 be used instead of related codes?

J45.30 should be used when a patient has mild persistent asthma without complications. It is important to differentiate it from J45.20 (mild intermittent asthma) and J45.31 (moderate persistent asthma) based on the frequency and severity of symptoms.

What documentation supports J45.30?

Documentation should include a detailed history of asthma symptoms, frequency of exacerbations, response to treatment, and results from lung function tests such as spirometry. Regular follow-up notes should also be included to demonstrate ongoing management.